eHealth Strategy for Romania Dr. Andrei KOZMA Minister of Health’s Adviser Sep 2010
Apr 01, 2015
eHealth Strategy for Romania
Dr. Andrei KOZMAMinister of Health’s Adviser
Sep 2010
Ministerul Sanatatii
Integrated Health Information System (IHIS)
eHealth vision
Future expectations
Electronic Data Management
Ministerul Sanatatii
Medical practice evolution:
From the treatment of acute illness, to the prevention of disease;
From considering each patient as an isolated entity, to perceiving the patient as a member of a population;
From a focus on the individual, to the broader perspective of public health
From paper documentation to an electronic, paperless environment
eHealth vision
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In order to obtain optimal results, a National Health Information Strategy is required:
Interoperability
Security
Data confidentiality
Cost-effectiveness
Standardisation
IHIS
eHealth visionMinisterul Sanatatii
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The eHealth system should be designed in a manner that would offer the best possible results for its main beneficiaries: the patients
IHIS
eHealth visionMinisterul Sanatatii
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Electronic Data Management
Patient related medical data, gathered in a consistent and uniform manner, nationwide, constitutes the Electronic Patient File (EPF), sometimes referred to as Electronic Medical Record (EMR)
EPF is generated at birth, is updated throughout the patient’s life and is stored in the system for an undetermined period of time.
EPFs must be interoperable, secure, consistent, safe and must ensure data confidentiality.
IHISMinisterul Sanatatii
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All medical service providers must contribute in the EPF in a standardized format.
This does not mean all medical service providers must use the same Health Information System, but the Ministry of Health should enforce the use of a minimum set of standards, in order to ensure interoperability.
The medical data stored in the EPF can be accessed by the authorised clinicians at any time and from any location.
Electronic Data ManagementIHISMinisterul Sanatatii
eHealth objectives (1/2):
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Improved quality, safety and efficiency of the clinical processes
Timely access to patient electronic medical data whenever and wherever they are needed
Patient access to their own medical records and to relevant health information
Communication and information exchange between multi-disciplinary medical teams
Future expectationsIHISMinisterul Sanatatii
eHealth objectives (2/2):
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Extensive use of international best practice guides and procedures
Unified national healthcare and health insurance data collection, both in the public and private health system
High level of security, confidentiality and control in relation to information management
Continuous health system improvement by ensuring a transparent and optimized reporting process
Implementation of a better informed health strategy
Future expectationsIHISMinisterul Sanatatii
Chronic Disease Management
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Chronic diseases: are long term conditions (over 6 months) are not contagious produce certain disfunctionalities or handicaps in most cases, do not improve over time are rarely healed completely
Chronic diseases are the main cause of death and morbidity, e.g. Europe (87% of all deaths, in high income countries, according to WHO – World Health Organisation)
Future expectationsIHIS
CDM represents a systematic approach to improving the quality of the medical services provided for the chronic disease patients.
Chronic Disease Management
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Instrument: an efficient system for the remote monitoring of chronic disease patients and the prevention of related medical complications
Future expectationsIHISMinisterul Sanatatii
Remote medical monitoring enables medical professionals to monitor a patient
remotely using various technological devices Improves the quality of life for chronic disease
patients, by reducing the number of hospital admissions
e.g. Electrocardiogram by phone
Telemedicine
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Interactive telemedicine services Teleradiology and teleconsultations:
shorter waiting lists, optimized use of resources
Future expectationsIHISMinisterul Sanatatii
Telemedicine
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Homecare devices and applications
Glycaemia measurement devices
Blood pressure measurement devices
Devices for the recording of vital signs and other clinical indicators
Future expectationsIHISMinisterul Sanatatii
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IHIS Major Components
Electronic Health RecordCDM – Chronic Disease Management
e-PrescribingHealth Cards
Ministerul Sanatatii
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Health Cards
Only after interoperability and infrastructure availability are ensured can we talk about a viable Electronic Health Card system implementation.
IHIS Major ComponentsMinisterul Sanatatii
The experience of other EU states regarding Health Cards indicates that, whenever an implementation was successful, the cards were used as identification devices, rather than data storage.
[ In Germany, the efforts made over the last 8 years to implement a National Health Card System have not materialized yet.]
Even so, we consider that the introduction of a Romanian Health Card could have beneficial effects if proper approach and goals are adopted.
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IHIS Major Components
Health Cards
Ministerul Sanatatii
Stores administrative information regarding health insurance.
Confirms the right of the patient to have access to medical treatment.
Health Card Functions
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Health CardsIHIS Major ComponentsMinisterul Sanatatii
Requirements:
new forms
new types of printers
reliable Internet connection
Introduction
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The existance of a well structured EPF system offers the basis for the implementation of a national ePrescribing system
e-PrescribingIHIS Major ComponentsMinisterul Sanatatii
Advantages of an electronic prescribing system:
clear prescription text
minimization of human errors, through the implementation of a prescription validation expert system
limitation of fraud risks to the system
facilitates efficient resource management
automatic reporting process
Introduction
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e-PrescribingIHIS Major ComponentsMinisterul Sanatatii
Prescription example (standard form)
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Medication details
2D Barcode – contains details about the medication and the patient
Unique identifier
Patient related data
1D Barcode – contains form number and doctor’s ID number
e-PrescribingIHIS Major ComponentsMinisterul Sanatatii
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Pre-requirements:
Standardized, complete and correct electronic medical data collection
Existence of IT tools for data analysis and statistical reports generation
Action: National EHR (Electronic Health Record) implementation
Objective: resource allocation and management according to national or even EU-level policies
Electronic Health RecordIHIS Major ComponentsMinisterul Sanatatii
EHR – Electronic Health Record
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EHR is a complex system (comprising of hardware, software, people, policies and processes) which:
Gathers data from multiple sources
Is used by clinicians as a primary information source at the point of care
Offers decision support in evidence based healthcare.
The term describes the highest level of functionality in medical data computerized management
Electronic Health RecordIHIS Major ComponentsMinisterul Sanatatii
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Information systems
Electronic Patient File
Medical service providers
Primary level
Decision level Decision
makers
Medical dataEconomic data
Electronic Health Record
eHealth system structure
Decisions
IHIS Major ComponentsMinisterul Sanatatii
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Conclusion
eHealth Strategy
Ministerul Sanatatii
This presentation, too brief - considering the importance of the issues in hand, aims to mark the importance of:
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Conclusions
eHealth Strategy
a coherent and stable (at least – for mid-term) eHealth strategy
proper definition of the roadmap and milestones
appropriate funding for each of the steps to be taken
Ministerul Sanatatii
Benefits:
Deployment at a national level of an integrated eHealth
system, part of a national eHealth Vision
Reuse of solutions and experience from similar
countries
Use of the state of the art technologies
Unique patient health record
Infrastructure and information to support the long term
health strategies
Improved health services and quality of lifeApril 11, 2023 26
Conclusions
eHealth Strategy
Ministerul Sanatatii
Thank you for your attention!
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eHealth Strategy for Romania
Dr. Andrei KOZMA
Ministerul Sanatatii